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Inflammatory Bowel Disease Clinical Activity is Associated with COVID-19 Severity Especially in Younger Patients.
Ricciuto, Amanda; Lamb, Christopher A; Benchimol, Eric I; Walker, Gareth J; Kennedy, Nicholas A; Kuenzig, M Ellen; Kaplan, Gilaad G; Kappelman, Michael D; Ungaro, Ryan C; Colombel, Jean-Frederic; Brenner, Erica J; Agrawal, Manasi; Reinisch, Walter; Griffiths, Anne M; Sebastian, Shaji.
  • Ricciuto A; SickKids IBD Centre, Division of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children.
  • Lamb CA; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.
  • Benchimol EI; Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
  • Walker GJ; Translational & Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
  • Kennedy NA; Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
  • Kuenzig ME; SickKids IBD Centre, Division of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children.
  • Kaplan GG; Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
  • Kappelman MD; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
  • Ungaro RC; ICES, Toronto, ON, Canada.
  • Colombel JF; Department of Gastroenterology, Torbay and South Devon NHS Foundation Trust, Torquay, UK.
  • Brenner EJ; Department of Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
  • Agrawal M; Exeter IBD Research Group, University of Exeter, Exeter, UK.
  • Reinisch W; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.
  • Griffiths AM; Department of Medicine, University of Calgary, Calgary, AB, Canada.
  • Sebastian S; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Crohns Colitis ; 16(4): 591-600, 2022 May 10.
Article in English | MEDLINE | ID: covidwho-1440612
ABSTRACT
BACKGROUND AND

AIMS:

Age is a major prognostic factor for COVID-19 outcomes. The effect of inflammatory bowel disease [IBD] activity on COVID-19 is unclear. We examined the relationship between IBD activity and COVID-19 severity according to age.

METHODS:

We included IBD patients diagnosed with COVID-19, reported to SECURE-IBD between March 13, 2020 and August 3, 2021. Clinical IBD activity was measured by physician global assessment [PGA]. COVID-19-related outcomes were [1] intensive care unit [ICU] admission, ventilation or death, and [2] hospitalization. Using generalized estimating equations, we determined adjusted odds ratios [aOR, 95% confidence interval] for moderate and severe PGA vs clinical remission/mild PGA, controlling for demographics, medications and COVID-19 diagnosis period. We performed stratified analyses by age [≤50 vs >50 years].

RESULTS:

Among 6078 patients, adverse COVID-19 outcomes were more common with active IBD ICU/ventilation/death in 3.6% [175/4898] of remission/mild, 4.9% [45/920] of moderate and 8.8% [23/260] of severe [p < 0.001]; and hospitalization in 13% [649/4898] of remission/mild, 19% [178/920] of moderate and 38% [100/260] of severe [p < 0.001]. Stratified by decade, effect sizes were larger for younger patients. In patients ≤50 years, severe PGA was independently associated with ICU/ventilation/death (aOR 3.27 [1.15-9.30]) and hospitalization (aOR 4.62 [2.83-7.55]). In contrast, severe PGA was not independently associated with COVID-19 outcomes in those older than 50 years.

CONCLUSIONS:

Clinically active IBD may be a risk factor for severe COVID-19, particularly in younger patients. IBD disease control, including through medication compliance, and strategies to mitigate the risk of COVID-19 infection amongst patients with active IBD [e.g. distancing, immunization] are key to limit adverse COVID-19 outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans / Middle aged Language: English Journal: J Crohns Colitis Journal subject: Gastroenterology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans / Middle aged Language: English Journal: J Crohns Colitis Journal subject: Gastroenterology Year: 2022 Document Type: Article